Don’t Wait Until You Are Sick To Get Well

I recently came across an article with this title and it really hit me. Of course it hit me in a way totally different than what the article intended. Being a medical biller thru and thru I immediately began thinking about the billing aspect of a doctor’s office. My first thought was “don’t wait until you’re receivables are so bad that you’re close to having to shut your doors before you seek help!” But it’s so true.

Most doctors don’t pay any attention to their billing until they are in financial trouble. Many go years and years losing thousands of dollars before they realize they are even in trouble. For me, that’s very troubling. I’m a bit of a perfectionist and also a numbers person. It’s hard for me to comprehend how someone can run a business but not pay any attention to the numbers. But doctors aren’t taught business end in medical school. Unless it comes naturally to them, or they hire someone that is handling that part for them (and handling it appropriately!) they are likely to lose money.

Time and time again we go into an office where they have someone in charge of their billing and they really don’t know much about it other than if there is anything left for them to draw after paying all the bills. They don’t know how many patients are being seen on a daily, weekly, or monthly. They are unaware of what percentage of their receivables are out over 30 days and what percentage is lost or written off. Most don’t know what criteria are even used to determine if charges need to be written off or are lost.

Unfortunately this type of doctor is the type that is likely to be taken advantage of. It is not always done intentionally. Sometimes the billing person is truly trying to do their best but they either don’t have the time to get to everything or they don’t have the training needed to do it. For example, many billers are thrown into the position without proper training. They may inherit the position because the previous biller left unexpectedly or the other biller may just not be able to get everything done so they pull another office worker in to help them. They may not be intentionally trying to cause the doctor to lose money but ultimately the job they are doing is doing just that.

And of course there are the billing or office managers out there that prey on doctors who do not pay attention. We read about them in the paper all the time. It’s really a shame, but it’s an unfortunate reality in this field. Some are doing it for their own personal gain, while others just do it because they have a poor attitude and just don’t care. Either way, they still get their pay check but the doctor ends up short.

We were aware of an office that was having serious problems with their receivables. They suspected that they were only receiving about half of what they should be. It literally took us years to finally get in to just take a look for them. It turned out they were losing over $250000 a year! Yup, a quarter of a million, every year. We figure it had been going on for over a 10 year period. Just in the couple years they had put us off they lost over $1 million. OK, so are you ready for the craziest part? You better be sitting down! We began doing their billing and we immediately doubled their income. After 2 years, they fired us because they had a “friend” starting her own medical billing business. The office manager that had been losing them $250000 a year still works there.

The dynamics of some offices leave me scratching my head. The whole time we worked for them we tried to get the office manager on board with us. We told her “we are bringing up the receivables and that makes you look good.” Her response was “I don’t care it’s his money, not mine.” Amazing how some people’s attitudes are. Here is a guy paying her a very good salary to run his office and she doesn’t care about the money coming in??? But what is he thinking? He let us go and kept her. And just for the record his income immediately dropped after we left by 40%. I know this because he told me.

So anyway, back to the point of the article. Why do so many doctors wait until they are in trouble before they seek help? Maybe they could relate if we use a medical analogy. Would they recommend a patient with diabetes wait until they are in a diabetic coma before seeking medical attention? Or would they recommend that the patient check their blood sugar at the first sign they aren’t feeling well? Maybe that’s not a good analogy. After all, I’m not a doctor. But I am a biller and I can say without a doubt that all providers should take some time to determine if their billing is going ok, if their receivables are in good shape, and if they need to make any changes. They should ask themselves the following questions:

• How many patients does the office see daily, weekly and monthly?
• How much money is out over 30 days? (What percentage?)
• Does my staff run regular aging reports and work them?
• Will my staff willingly give me reports so that I can see what’s happening?
• Does the patient billing go out regularly?
• How are denials handled? (How quickly, what methods)
• What percentage are we losing, or writing off as bad debt?

That is a good place to start. If the answers to the above questions are causing you any alarm, you may want to consider consulting with someone to review your office billing procedures to see if there are any serious issues, or if there are some things you can do to improve the situation. If you are a billing service you can use the above questions to ask a provider to get them to give you a chance to come in and do an analysis for them.


One Response to “Don’t Wait Until You Are Sick To Get Well”

  1. Virginia Says:

    I totally agree with you. I have been a biller, manager, teacher, practice administrator, and now I work accounts receiveables for a Nephrology group in California. They had a person working the patient receivables and she really did not understand about copays vs coinsurance, nor how to look at the account to determine if the patient really owed the amount.

    she is no longer with the company and it has taken me some time to get the accounts corrected, but at least now we have a better and more acccurate report. Now its the insurance side that is being tackled. Many doctors do not know that their receivables will make or break them until it is too late, then again, many doctors do not want you to see their receivables so that you can help them. I love working receivables, once you know how to play the game with the insurance companies, it is so much easier to get claims paid.

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